How does trauma affect sleep?

Difficulty sleeping is one of the most common symptoms that affect trauma survivors. Research shows nine in 10 people with post-traumatic stress disorder (PTSD) report difficulty sleeping. And it goes both ways: Not only does trauma make it more difficult to sleep, but not sleeping well also makes you more vulnerable to developing and experiencing PTSD symptoms.

If you’re having trouble sleeping after a traumatic event, it’s important to take steps to get the support you deserve, improve your sleep, and reclaim your life.

What’s the relationship between trauma and sleep?

Trauma and sleep have a bidirectional relationship, which means that each affects the other. Sleep disturbances are some of the most commonly reported symptoms in people experiencing trauma. People who’ve gone through a traumatic event but don’t develop symptoms of PTSD often have trouble sleeping.

Several aspects of life after trauma can contribute to sleep problems.

First, one of the symptoms of PTSD is hypervigilance, or a sense of always being on guard. Trauma takes away your sense of safety in the world, and your nervous system may be constantly on the lookout for additional dangers. This can make it hard to wind down and get restful sleep at night.

The hypervigilance and anxiety that come along with PTSD can also cause increased muscle movements in the hands and legs while asleep. This can interrupt sleep quality and wake you during the night.

Another symptom of PTSD is avoidance. After going through trauma, many people try their best to avoid thinking about or being reminded of the event. While they may be successful in avoiding reminders during their waking hours, the memories may play back as nightmares while asleep.

Lastly, PTSD and substance use disorder often go hand in hand. Up to half of people who are treated for substance use disorder also display symptoms of PTSD. While substances like alcohol and cannabis may seem to help you sleep, they actually cause poor quality sleep in the long run.

Not only does experiencing trauma make it more difficult to sleep, but having sleep difficulties can increase your vulnerability to developing PTSD. Part of this is due to the role sleep plays in processing emotions and memories, which scientists are still trying to understand. Research shows that having sleep difficulties makes you more likely to develop PTSD symptoms after going through a traumatic event.

Signs trauma is impacting your sleep

People with PTSD are more likely to experience all types of sleep disorders. For people who’ve experienced trauma, the most common sleep disturbances include:

• Insomnia: Difficulty falling or staying asleep, often caused by hypervigilance or anxiety, is a symptom often seen in people who’ve experienced trauma.
• Nightmares: Replaying traumatic events in dreams, which can wake you up and make sleep feel unsafe, is also a common symptom in people who’ve experienced trauma.
• Poor sleep quality: Feeling tired or unrested, even after a full night of sleep, is another common symptom after experiencing trauma.
• Not long enough sleep: Trauma survivors may wake up frequently during the night or too early in the morning, or not be able to fall asleep at night.
• Reduced time in REM sleep: Trauma can reduce time spent in REM sleep, the stage where dreams and emotional processing occur.
• Parasomnias like sleepwalking or night terrors: These challenges can be triggered or worsened by trauma and can make it hard to get adequate rest. 
• Restless leg syndrome: People with PTSD often experience periodic limb movement disorder, a condition that involves involuntary movements that can disturb your sleep.
• Obstructive sleep apnea: PTSD is also linked with sleep apnea, a condition in which breathing repeatedly stops and starts during sleep, often worsened by stress.
• Fear of losing control while asleep: Trauma survivors may fear letting their guard down, especially if others live in the home, leading to avoidance of sleep.

Does disturbed sleep from trauma ever go away?

Sleep disturbances associated with trauma can last years. For example, according to one report, people who had survived traumas like the Holocaust or devastating earthquakes experienced sleep problems for decades after the event.

But this doesn’t mean that you’ll necessarily experience poor sleep for the rest of your life. There are ways to manage your trauma and reduce PTSD symptoms including disturbed sleep.

Not everyone who goes through a traumatic event will develop PTSD. You may have temporary sleep disturbances after a traumatic event that goes away over time. But if you develop symptoms of PTSD, it’s important to get the right treatment. PTSD is a serious mental health condition, but many effective treatment strategies can help.

How to get better sleep after trauma

If you’re experiencing trouble sleeping after going through a traumatic event, it’s important to address this as soon as possible. Poor sleep can worsen PTSD symptoms and may also put you at higher risk for other mental health conditions, like depression and anxiety. A combination of lifestyle changes and therapy can help. 

Explore these tips: 

• Create a sleep sanctuary. Turn your bedroom into a peaceful, calming environment. Keep the space cool, dark, and quiet, and remove distractions like electronics. Invest in a comfortable mattress and consider using white noise machines or blackout curtains to block out external stimuli.
• Avoid caffeine and alcohol. Both caffeine and alcohol can disrupt your sleep cycle. Try to avoid caffeine in the afternoon and evening, and limit alcohol intake, as it can lead to fragmented sleep — even if it might temporarily help. 
• Set a routine. Go to bed and wake up at the same time every day, even on weekends. A consistent sleep schedule helps regulate your body’s internal clock and makes it easier to fall and stay asleep.
• Engage in exercise. Physical activity can reduce symptoms of PTSD and improve sleep quality. Aim for at least 20 to 30 minutes of exercise most days, but avoid vigorous activity close to bedtime, as it might make it harder to fall asleep.

Therapy to help process trauma and sleep better

Therapy — especially trauma-focused therapy — can help you process your experience and reduce symptoms like hypervigilance and nightmares. Treatments like eye movement desensitization and reprocessing (EMDR) can be especially effective in helping you move forward from a traumatic experience.

Additionally, cognitive behavioral therapy for insomnia (CBT-I) is an evidence-based treatment approach that can help you overcome difficulty sleeping. Medication can also help in some cases, but it’s important to work with your provider to find the right option for you. 

Find care with Rula

Having a difficult time sleeping after you experience a traumatic event is completely natural. But trauma doesn’t have to control your life — or your sleep. With the right support, you can heal and get the rest you deserve. 

Rula has helped hundreds of thousands of patients find affordable, quality, in-network therapy. We boast 10,000+ licensed therapists with expertise in trauma and insomnia, as well as over 80 clinical specialties.

Start Rula today